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Anders Larsson

Publications and source records attributed to Anders Larsson.

At least 73 records · Page 4Linked to original sources
PubMed2003

[Septic shock--a condition with great potential for improvement. Management and therapy].

There is a recent focus upon treatment of septic shock, related to the publication of a number of interesting studies during the last two years. These studies indicate that patient outcome can be improved, provided care is organized so as to optimize and expedite initial treatment of the patient in septic shock. In parallel, new drugs have been launched using rather aggressive marketing, which calls for recommendations and advice from professional experts who are independent of the pharmaceutical industry. This article reviews the studies that have engendered a new optimism in the treatment of septic shock. These "new" therapies are presented in a total context with a temporal perspective. It is suggested that emergency sepsis teams be instituted at hospitals.

Critical Care↗
PubMed2003

Characteristics of human prostasomes isolated from three different sources.

BACKGROUND: Prostasomes are organelles secreted by human prostate epithelial cells and appear freely in semen. Most prostasomal functional and biochemical characteristics have been settled on basis of seminal prostasomes (SP). METHODS: Three types of prostasomes, viz., from seminal plasma, prostate gland (native), and prostate cancer bone metastasis, were isolated and compared for their biochemical and functional characteristics. RESULTS: Flow cytometry showed that all three types of prostasomes had a similar size distribution and electrophoresis revealed close similarities in banding pattern. Also, a high cholesterol/phospholipid ratio and some marker enzymes were distinctive common features. The unusual chromogranin B (CgB)/chromogranin A (CgA) ratio with CgB in abundance over CgA, previously found only in SP, was also valid for the native (NP) and metastasis-derived prostasomes (MP). The latter prostasome type contained a 10-fold higher amount of CgA compared to the others. SP and MP showed the same promotive effect on sperm forward motility, whereas NP did not. All three prostasome types exhibited an antibacterial activity against Bacillus megaterium. CONCLUSIONS: Since the three prostasome types were isolated from different environments, our data support the view that the common characteristics were prostasome-genuine.

Aminopeptidases↗
PubMed2003

Oral administration of specific yolk antibodies (IgY) may prevent Pseudomonas aeruginosa infections in patients with cystic fibrosis: a phase I feasibility study.

Respiratory infection is the major cause of morbidity and mortality in cystic fibrosis (CF) patients. Chronic Pseudomonas aeruginosa (PA) infections ultimately occur in virtually all patients. It is impossible to eradicate PA when a patient has been chronically colonized. Immunotherapy with specific egg-yolk antibodies (IgY) may be an alternative to antibiotics for the prevention of PA infections. We wanted to determine if treatment with specific IgY can prolong the period between the first and the second PA colonization? And long-term, can the treatment diminish the number of positive PA cultures and postpone the onset of chronic colonization? CF patients gargled daily with an IgY-antibody preparation, purified from eggs of hens immunized with PA bacteria. They were compared to a group of patients who did not gargle with the preparation. Both groups had their first colonization with PA eradicated by antibiotics. The basic treatment was essentially the same in both groups. In the initial study, the period between the first and second colonization with PA was significantly prolonged for the treated vs. the control group (Kaplan-Meier P = 0.015, Breslow test). In the prolonged study, the treated group had only 2.5 sputum cultures positive for PA per 100 months of observation, and none of these patients became chronically colonized with PA. No adverse events were reported. In the control group, 13.7 cultures per 100 months of observation were positive for PA, and 5 (24%) patients became chronically colonized with PA. This feasibility study shows that antipseudomonal IgY has the potential to effectively prevent PA colonization without any severe adverse effects. A phase III study should be initiated.

Adolescent↗
PubMed2003

Evaluation of laboratory markers for the detection of infections in open-heart surgery patients.

This study compared the efficiency of interleukin-6 (IL-6), human neutrophil lipocalin (HNL), C-reactive protein (CRP) and white blood cell (WBC) count for the early detection of postoperative bacterial infections after open-heart surgery. These laboratory markers were determined preoperatively and monitored daily during the first 6 postoperative days. Postoperative bacterial infections were diagnosed in 17 of 54 studied patients needing at least 3 d of intensive care. Patients with less than 3 d of intensive care were not studied. HNL and WBC count showed no significant differences between infected and non-infected groups, whereas both IL-6 and CRP were significantly higher in the infected group. IL-6 levels were higher (p < 0.01) in the infected patients on the first postsurgical day, although with considerable interindividual variation. CRP levels rose on the second postsurgical day and showed less variation (p < 0.01). Calculation of the differences between preoperative and postoperative levels of IL-6 and CRP was not helpful for early detection of postoperative infections. Although IL-6 showed an earlier mean rise than CRP in patients developing postoperative infection, its substantial interindividual variation limits its clinical usefulness. HNL and WBC counts were ineffectual as indicators of postoperative infections in this study.

Adult↗
PubMed2003

Mucosal secretion and expression of basic fibroblast growth factor in patients with collagenous colitis.

OBJECTIVES: Collagenous colitis (CC), a condition of unknown ethiology and pathophysiology, is characterized by watery diarrhea and increased amounts of collagen in the colonic mucosa. Basic fibroblast growth factor (bFGF) is a potent multifunctional growth factor that stimulates proliferation and differentiation of fibroblasts that was recently detected in high intraluminal concentrations in patients with ulcerative colitis. In this study we examined the secretion and expression of bFGF in the colorectal mucosa of patients with CC. METHODS: Ten CC patients and 10 control patients underwent colonoscope-based segmental perfusion of the descending colon and rectum. The concentrations of bFGF in perfusate and serum were determined by immunochemical methods, and the expression of bFGF was analyzed immunohistochemically in biopsy samples from colonic mucosa. RESULTS: The median concentrations of bFGF in perfusates from the descending colon and rectum were increased 4-fold in CC patients compared with control patients. The median concentration of bFGF in serum was not significantly different in patients and controls. Immunohistochemical staining of bFGF was located in the colorectal epithelial cells and in exsudate on the luminal side of these cells. In the lamina propria, inflammatory cells and fibroblasts contained bFGF. There were no differences in the intensity of bFGF staining in surface epithelium or lamina propria between patients and controls. CONCLUSIONS: Local investigation of the colorectal mucosa seems to be crucial when studying the pathophysiology of CC. Increased colorectal mucosal secretion of bFGF in patients with CC may promote differentiation of fibroblasts and thereby lead to increased subepithelial collagen deposition.

Adult↗
PubMed2003

Assessing urinary albumin excretion in pre-eclamptic women: which sample to use?

OBJECTIVE: To evaluate whether the gold standard of 24-hour urine collection for measuring albumin excretion in pre-eclamptic women could be substituted by shorter collection periods. DESIGN: Prospective study. SETTING: Fetal maternity ward, university hospital. PARTICIPANTS: Thirty women with pre-eclampsia and a positive urinary test strip for protein of at least 2+. METHODS: From each woman, within a 25-hour period, three spot, two 12-hour (day and night) and one 24-hour urine sample were collected. Urine albumin concentrations in milligrammes per litre were analysed by rate nephelometry on a Beckman Array protein system. The urinary albumin concentrations in the spot and the 12-hour samples were compared with the concentration in the 24-hour urine collection. MAIN OUTCOME MEASURES: Urinary albumin concentrations in spot and 12-hour samples measured against the standard 24-hour albumin excretion. RESULTS: Albumin concentrations in the day and night collection fitted closely with the concentrations of the 24-hour collection. The median difference between the 24-hour and the day collection was -3 mg/L (interquartile range -264 to 116 mg/L). The median difference between the 24-hour and the night collection was 17 mg/L (interquartile range -186 to 210 mg/L). The association of urinary albumin concentration in the 24-hour collection and the spot samples was much weaker. Of the spot urine samples, the albumin concentration in the sample taken on the morning after admission to hospital was closest to the 24-hour urinary albumin excretion, with a median difference of -62 mg/L (interquartile range -1131 to 285 mg/L). CONCLUSION: The gold standard of 24-hour urinary excretion for assessment of albuminuria in pre-eclamptic women can be substituted with a 12-hour collection. Spot urine samples were inaccurate and are therefore not recommended for quantification of albumin excretion.

Adult↗
PubMed2003

Oral immunotherapy with yolk antibodies to prevent infections in humans and animals.

There is an increasing prevalence of antibiotic-resistant bacteria, which makes traditional antibiotics less effective. It is thus important to find an alternative to the use of antibiotics. Oral administration of specific antibodies is an attractive approach to establish protective immunity against gastrointestinal pathogens in humans and animals. Immunotherapy can also be used against pathogens that are difficult to treat with traditional antibiotics. Laying hens are good producers of specific antibodies. After immunisation, the specific antibodies are transported to the egg yolk from which the antibodies (IgY) can be purified in large quantities. Eggs are also normal dietary components and thus there is practically no risk of toxic side effects of IgY. Yolk antibodies have been shown in several studies to prevent both bacterial and viral infections. We have treated one patient with yolk antibodies against P. aeruginosa daily for more than eight years, which shows that it is possible to use yolk immunotherapy over long treatment periods.

Administration, Oral↗
PubMed2003

NOSTOS: a paper-based ubiquitous computing healthcare environment to support data capture and collaboration.

In this paper, we present a new approach to clinical workplace computerization that departs from the window-based user interface paradigm. NOSTOS is an experimental computer-augmented work environment designed to support data capture and teamwork in an emergency room. NOSTOS combines multiple technologies, such as digital pens, walk-up displays, headsets, a smart desk, and sensors to enhance an existing paper-based practice with computer power. The physical interfaces allow clinicians to retain mobile paper-based collaborative routines and still benefit from computer technology. The requirements for the system were elicited from situated workplace studies. We discuss the advantages and disadvantages of augmenting a paper-based clinical work environment.

Computer Peripherals↗
PubMed2002

VEGF is increased in serum but not in spinal cord from patients with amyotrophic lateral sclerosis.

Homogenates of postmortem spinal cord from seven patients with amyotrophic lateral sclerosis (ALS) and six controls together with serum from 13 patients with ALS and 13 controls were analysed for vascular endothelial growth factor (VEGF) using an immunoassay (ELISA). There was no significant difference in VEGF levels in the spinal cord between the ALS patients and the controls. In serum the VEGF levels were significantly higher in the ALS group than in the control group. There was a moderate inverse relation between the duration of the disorder and the serum VEGF levels. The findings indicate that the capacity to synthesize VEGF is preserved even in the late stages of ALS. The results might also be consistent with a transient hypoxic component during the course of ALS, but not with a persistant spinal hypoxia in the late stages of the disorder.

Adult↗
PubMed2002

Lung recruitment manoeuvres are effective in regaining lung volume and oxygenation after open endotracheal suctioning in acute respiratory distress syndrome.

INTRODUCTION: Lung collapse is a contributory factor in the hypoxaemia that is observed after open endotracheal suctioning (ETS) in patients with acute lung injury and acute respiratory distress syndrome. Lung recruitment (LR) manoeuvres may be effective in rapidly regaining lung volume and improving oxygenation after ETS. MATERIALS AND METHOD: A prospective, randomized, controlled study was conducted in a 15-bed general intensive care unit at a university hospital. Eight consecutive mechanically ventilated patients with acute lung injury or acute respiratory distress syndrome were included. One of two suctioning procedures was performed in each patient. In the first procedure, ETS was performed followed by LR manoeuvre and reconnection to the ventilator with positive end-expiratory pressure set at 1 cmH2O above the lower inflexion point, and after 60 min another ETS (but without LR manoeuvre) was performed followed by reconnection to the ventilator with similar positive end-expiratory pressure; the second procedure was the same as the first but conducted in reverse order. Before (baseline) and over 25 min following each ETS procedure, partial arterial oxygen tension (PaO2) and end-expiratory lung volume were measured. RESULTS: After ETS, PaO2 decreased by 4.3(0.9-9.7)kPa (median and range; P < 0.005). After LR manoeuvre, PaO2 recovered to baseline. Without LR manoeuvre, PaO2 was reduced (P = 0.05) until 7 min after ETS. With LR manoeuvre end-expiratory lung volume was unchanged after ETS, whereas without LR manoeuvre end-expiratory lung volume was still reduced (approximately 10%) at 5 and 15 min after ETS (P = 0.01). DISCUSSION: A LR manoeuvre immediately following ETS was, as an adjunct to positive end-expiratory pressure, effective in rapidly counteracting the deterioration in PaO2 and lung volume caused by open ETS in ventilator-treated patients with acute lung injury or acute respiratory distress syndrome.

Aged↗
PubMed2002

[Modest clinical benefits of ASAT analysis in today's health care. A case report of macro-ASAT giving rise to pathologically increased ASAT levels].

Aspartate aminotransferase (AST) may occur as a macroenzyme after forming a complex with immunoglobulins. The complex results in decreased plasma clearance and thus elevated AST levels. So far, macro-AST has only been described in a few patients. Here, we report a case of macro-AST in a healthy female. Clinicians should be aware of this phenomenon so that patients are not subjected to unnecessary investigations.

Adult↗
PubMed2002

Input waveguide grating couplers designed for a desired wavelength and polarization response.

Input grating couplers are used to couple light from free space into a waveguide and can provide additional functions such as focusing and beam splitting of the light into arbitrary desired positions in the waveguide. We show that it is possible to design the couplers so that they perform different desired functions depending on the polarization or wavelength of the incident light. We demonstrate experimentally a number of couplers that may be of interest, e.g., in optical fiber communications. Examples are polarization-independent couplers, designed to have the same response for two orthogonal polarizations of the incident light, and couplers for demultiplexing in wavelength division multiplexing applications, designed to separate and focus different input wavelengths to different positions in the waveguide.

Journal Article↗
PubMed2002

Stability of polycarbonate and polystyrene surfaces after hydrophilization with high intensity oxygen RF plasma.

A general drawback observed with plasma treatment is the limited stability of the hydrophilic-treated surfaces toward washing, storage, or heating. It has recently been found that oxygen, air, or argon radiofrequency plasmas with higher intensities than normally used can give hydrophilic surfaces having good wash stability. High intensity oxygen plasma treatment of polystyrene and polycarbonate surfaces was therefore carried out using two different capacitively coupled RF reactors with internal shelf electrodes. The obtained surface characteristics and stability were evaluated using contact angle measurements, XPS, AFM, and nanoindentation. For both materials, low water contact angles were found to correlate with high surface oxygen content. Only the surfaces exposed to relatively intense treatments, with self-bias voltages above 140 V (polystyrene) or 240 V (polycarbonate), could withstand washing in ethanol and remain highly hydrophilic. Substantial amounts of nonsoluble material were observed on the plastic substrates after treatment. Furthermore, for polycarbonate Young's modulus of the surface was found to increase with increasing intensity of the plasma. These observations were taken as an indication that extensive cross-linking of the surface layer took place. After more than 6 months of storage, the samples treated with the most intense plasmas (self-bias voltages in the range of 480-600 V) still had water contact angles around 20 degrees .

Oxygen↗
PubMed2002

Genetic links between the acute-phase response and arthritis development in rats.

OBJECTIVE: The acute-phase inflammatory response is closely correlated with the development of rheumatoid arthritis, but the pathophysiologic role of its specific components is largely unknown. We investigated the genetic control of the acute-phase protein response in pristane-induced arthritis (PIA), which is a chronic erosive arthritis model in rats. METHODS: Plasma levels of the acute-phase proteins interleukin-6 (IL-6), alpha1-acid glycoprotein (orosomucoid), fibrinogen, and alpha1-inhibitor3 were quantified in 3 strains of rats during the development and progression of disease: DA and LEW.1F, which are susceptible to arthritis, and E3, which is resistant. Genetic linkage analysis was performed on an F2 intercross between E3 and DA to determine the genetic control of the acute-phase response in arthritis. Elevated levels of alpha1-acid glycoprotein were associated with acute inflammation, whereas levels of IL-6 were increased during the entire course of the disease. RESULTS: Using these acute-phase markers as quantitative traits in linkage analysis revealed a colocalization of loci controlling the acute-phase response and regions previously shown to control the development of arthritis in chromosomes 10, 12, and 14. In addition, 2 loci that were not associated with arthritis were found to regulate serum levels of the acute-phase protein Apr1 (acute-phase response 1) at the telomeric end of chromosome 12 and Apr2 on chromosome 5. CONCLUSION: The PIA model in rats is a useful tool for understanding some of the pathways leading to chronic erosive arthritis. The analysis of acute-phase proteins in PIA and its application as quantitative traits for studying the genetics of arthritis will promote the understanding of the genetic regulation of the acute-phase response.

Acute Disease↗